Vaccines and Global Health: The Week in Review 23 April 2016

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

pdf version A pdf of the current issue is available here:  Vaccines and Global Health_The Week in Review_23 April 2016

blog edition: comprised of the approx. 35+ entries posted below on 24 April 2016.

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

.
David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy
a program of the
– Division of Medical Ethics, NYU Medical School
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

World Immunization Week 2016: Close the immunization gap

World Immunization Week 2016: Close the immunization gap
21 April 2016 | Geneva – During World Immunization Week 2016, held 24-30 April, WHO highlights recent gains in immunization coverage, and outlines further steps countries can take to “Close the Immunization Gap” and meet global vaccination targets by 2020.

“Last year immunization led to some notable wins in the fight against polio, rubella and maternal and neonatal tetanus,” says Dr Margaret Chan, WHO Director-General. “But they were isolated wins. Polio was eliminated in 1 country, tetanus in 3, and rubella in 1 geographical region. The challenge now is to make gains like this the norm.”

Immunization averts 2 to 3 million deaths annually; however, an additional 1.5 million deaths could be avoided if global vaccination coverage improves. Today, an estimated 18.7 million infants – nearly 1 in 5 children – worldwide are still missing routine immunizations for preventable diseases, such as diphtheria, pertussis and tetanus…

Zika virus [to 23 April 2016]

Zika virus [to 23 April 2016]
Public Health Emergency of International Concern (PHEIC)
http://www.who.int/emergencies/zika-virus/en/

.

Zika situation report
14 April 2016
Zika virus, Microcephaly and Guillain-Barré syndrome
Read the full situation report
Summary
:: From 1 January 2007 to 20 April 2016, Zika virus transmission was documented in a total of 66 countries and territories.

:: Mosquito-borne transmission:
>> 42 countries are experiencing a first outbreak of Zika virus since 2015, with no previous evidence of circulation, and with ongoing transmission by mosquitos.
>> 17 countries have reported evidence of Zika virus transmission prior to 2015, with or without ongoing transmission or have reported an outbreak since 2015 that is now over.

:: Person-to-person transmission:
>> Eight countries have now reported evidence of person-to-person transmission of Zika virus, other than mosquito-borne transmission (Argentina, Chile, France, Italy, New Zealand, Peru, Portugal and the United States of America).

:: In the week to 20 April, no additional countries have reported mosquito-borne Zika virus transmission. Peru and Portugal are the latest countries to report person-to-person transmission.

:: Microcephaly and other fetal malformations potentially associated with Zika virus infection or suggestive of congenital infection have been reported in six countries (Brazil, Cabo Verde, Colombia, French Polynesia, Martinique and Panama). Two cases, each linked to a stay in Brazil, were detected in Slovenia and the United States of America. A further case, linked to a brief stay in Mexico, Guatemala and Belize, was detected in a pregnant woman in the United States of America.

.

Disease Outbreak News (DONs)
:: 22 April 2016 Zika virus infection – Papua New Guinea
:: 21 April 2016 Zika virus infection – Peru
:: 20 April 2016 Zika virus infection – Saint Lucia

.

Zika Open [to 23 April 2016]
[Bulletin of the World Health Organization]
:: All papers available here New papers below:
Analysis of the genetic divergence in Asian strains of ZIKA virus with reference to 2015-2016 outbreaks
– Jatin Shrinet, Aditi Agrawal, Raj K Bhatnagar & Sujatha Sunil
Posted: 22 April 2016
http://dx.doi.org/10.2471/BLT.16.176065
pdf, 2.38Mb

Clinical comparison, standardization and optimization of Zika virus molecular detection
– Victor M. Corman, Andrea Rasche, Cecile Baronti, Souhaib Aldabbagh, Daniel Cadar, Chantal B.E.M. Reusken, Suzan D. Pas, Abraham Goorhuis, Janke Schinkel, Richard Molenkamp, Beate M. Kuemmerer, Tobias Bleicker, Sebastian Brünink, Monika Eschbach-Bludau, Anna M. Eis-Hübinger, Marion P. Koopmans, Jonas Schmidt-Chanasit, Martin P. Grobusch, Xavier de Lamballerie, Christian Drosten, & Jan Felix Drexler
Posted: 19 April 2016
http://dx.doi.org/10.2471/BLT.16.175950

.

CDC/ACIP [to 23 April 2016]
http://www.cdc.gov/media/index.html
FRIDAY, APRIL 22, 2016
CDC and OSHA Issue Interim Guidance for Protecting Workers from Occupational Exposure to Zika Virus
The Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) today issued new guidance and information for protecting workers from occupational exposure to Zika…

MONDAY, APRIL 18, 2016
CDC adds Belize to interim travel guidance related to Zika virus
CDC is working with other public health officials to monitor for ongoing Zika virus? transmission. Today, CDC posted a Zika virus travel notice for Belize. CDC has issued travel notices…

MMWR April 22, 2016 / Vol. 65 / No. 15
:: Patterns in Zika Virus Testing and Infection, by Report of Symptoms and Pregnancy Status — United States, January 3–March 5, 2016

EBOLA/EVD [to 23 April 2016]

EBOLA/EVD [to 23 April 2016]
“Threat to international peace and security” (UN Security Council)

Editor’s Note:
Following last week’s decision by WHO, we have removed the Public Health Emergency of International Concern (PHEIC) designation we have carried above. We have not identified any action by the UN Security Council to change the “Threat to international peace and security” designation. We will continue to present Ebola updates in this space for the near-term, and monitor whether the Security Council takes action on the threat designation.
The last “Ebola Situation Update” is dated 30 March 2016 and we observe that WHO has established an Ebola Situation Report archive, indicating that this may be the final situation report. There is no announcement on this evident on the website.

.

The role of training in the West Africa Ebola response
April 2016
The magnitude of the 2014-2015 West Africa Ebola outbreak combined with a dearth of local and international expertise in tackling the disease necessitated training on a mass scale. Over the duration of the epidemic, WHO and partners trained more than 8,000 health professionals from over 80 nations, including the Ebola-affected countries.

The training courses focused on protecting first responders through disease-specific information and safety measures and preparing them for a range of specific Ebola response functions, including treatment of Ebola patients, case tracking, safe burials, epidemiology and infection prevention and control.
To better understand the impact of the trainings, WHO commissioned a review, which was conducted by an independent, external body.

:: Read the review, its conclusions and its recommendations

POLIO [to 23 April 2016]

POLIO [to 23 April 2016]
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 20 April 2016
:: The globally synchronized switch from the trivalent to bivalent oral polio vaccine, the first stage of objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018, is underway between 17 April and 1 May. Follow a live update of which countries have undergone the switch here. Learn more about the rationale for the switch through this series of videos.

:: The Strategic Advisory Group of Experts on immunization (SAGE) met on the 12 to 14 April to discuss polio eradication. The official report from there meeting is available here.

:: The final communique of the Organisation of Islamic Cooperation (OIC) Istanbul Summit, adopted by OIC Heads of State and Government, reaffirmed the importance of preserving the health and wellbeing of children as a duty of parents and society as prescribed by Islam, and appealed to religious scholars and leaders to support polio eradication efforts.

:: The World Health Assembly (WHA) Report on Poliomyelitis has been published. The report summarises the status against the Polio Endgame Plan and Resolution WHA68.3, adopted by the WHA in May 2015.

:: Around the world, countries that remain vulnerable to polio are continuing to vaccinate children and build immunity, as shown in Jordan through this series of photographs.

Selected Country Levels Updates [excerpted]
Afghanistan
:: One new case of wild poliovirus type 1 (WPV1) was reported in the past week in Shigal Wa Shelten district of Kunar province with onset of paralysis on 27 March. The total number of WPV1 cases for 2016 is now three, compared to one reported by this date in 2015.
Pakistan
:: One new WPV1 environmental positive sample was reported in the past week from Sukkur district of Sindh province, with a collection date of 19 March.
:: Efforts continue to further strengthen surveillance activities in all provinces of the country to ensure that no child is missed with the vaccine
Madagascar
:: The third Outbreak Response Assessment in Madagascar found that the surveillance system is not yet strong enough to conclude that polio transmission has been interrupted. Thirty-nine high-risk districts have been identified to receive focused attention.

.

Pakistan polio: Seven killed in anti-vaccination attack
BBC News – 20 April 2016
Seven Pakistani policemen, three of whom were guarding polio workers, have been killed in Karachi, officials say.
Eight gunmen on motorcycles fired at a group of three police guards and later at a van containing four officers, officials told the Pakistan Tribune.

Islamist militants oppose vaccination, saying it is a Western conspiracy to sterilise Pakistani children.

In January, 15 people were killed in a bomb attack on a vaccination centre in the south-western city of Quetta.

Reward
Polio workers called off the vaccination drive in Karachi following the attack, despite the home minister’s order to continue, the Tribune reported.

According to Pakistan’s Dawn newspaper, police have offered a reward of 5 million rupees (£33,000) for information on the killers, and 2 million rupees (£13,000) compensation to the victims’ families.

Talking to reporters at the scene, Sindh police Inspector General AD Khawaja said polio drops would be “administered to our children at all costs” and said security for polio teams would be increased…

.

Vaccination Boost for Pakistan’s Children: World Bank and Partners Provide New Funding for Immunization
Washington DC, April 21, 2016—The World Bank approved today an International Development Association (IDA) credit of $50 million to increase the availability of vaccines for infectious diseases, including polio, for children under two years of age in Pakistan.

The National Immunization Support Project (NISP) is supporting the country’s Expanded Program on Immunization (EPI) that aims to immunize all children against eight vaccine preventable diseases: tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus, hepatitis B, haemophilus influenza type b (Hib), and measles. Strengthening EPI will also support Pakistan’s access to newer vaccines which are either in the process of roll out (pneumococcal vaccine) or under planning (rotavirus vaccine).

The Project is also receiving additional support of $80 million grant from a World Bank administered multi-donor trust fund, Gavi – the Vaccine Alliance, and the United States Agency for International Development. The Bill and Melinda Gates Foundation is also supporting the project through an innovative partial conversion of the IDA credit into a grant upon successful achievement of project objectives.

“Pakistan is grappling with the public health emergency of polio virus transmission. Ensuring strong routine immunization services is the first essential pillar in polio eradication”, says Illango Patchamuthu, World Bank Country Director for Pakistan. “The World Bank and other development partners are working with the Government of Pakistan to strengthen routine immunization services at the critical endgame stage of polio eradication, particularly as Pakistan introducesinjectable polio vaccine into its routine schedule”.

The project will incentivize provincial government capacity for rigorous monitoring and effective implementation of its program, including strengthened vaccine logistics, and deploying and expanding qualified technical and managerial personnel.

“Pakistan’s performance in maternal and child health remains weak and inadequate immunization coverage is a major challenge. Childhood immunization against vaccine preventable diseases can help in significant reductions in disability and death”, says Robert Oelrichs, World Bank Task Team Leader of the Project. “The project will establish linkages of the federal and provincial EPI cells with private sector health providers and health-related civil society organizations (CSOs) working in low coverage catchment areas – especially urban slums.”

Children under two years of age in Pakistan are the main beneficiaries of NISP – particularly children belonging to the poorest households in which immunization coverage is lowest. In addition, all children will benefit from strengthened polio and measles interventions.

The credit is financed by IDA, the World Bank’s fund for the poor, with a maturity of 25 years, including a grace period of 5 years.

.

WHO African Region AFRO
:: African countries withdraw type 2 component of polio vaccine
Brazzaville, 22 April 2016 – As the world gets closer to global polio eradication, all 47 countries in the African Region are joining the rest of the world to switch from trivalent Oral Polio Vaccine (tOPV) to bivalent Oral Polio Vaccine (bOPV) in routine immunization schedules.

.
WHO Eastern Mediterranean Region EMRO
:: National polio immunization campaign concludes in Yemen
Sana’a, 21 April 2016 – This week, a national house-to-house polio immunization campaign, organized by the Ministry of Public Health and Population and supported by WHO and UNICEF, concluded in Yemen. More than 4.5 million children under the age of 5 were successfully vaccinated by more than 40 000 health workers. Yemen has been polio free since 2006.
:: Libya completes first polio campaign since 2014 21 April 2016
:: Keeping up the fight against polio: maintaining population immunity in Jordan 19 April 2016

WHO & Regional Offices [to 23 April 2016]

WHO & Regional Offices [to 23 April 2016]

Weekly Epidemiological Record (WER) 22 April 2016, vol. 91, 16 (pp. 209–216)
Contents:
209 Meningitis control in countries of the African meningitis belt, 2015

.
Call for expressions of interest on tablet and smartphone app regarding in WHO Immunization Summary pdf, 50kb
18 April 2016
Deadline for application: 13 May 2016

.
Disease Outbreak News (DONs)
:: 22 April 2016 Cholera – United Republic of Tanzania
:: 22 April 2016 Yellow Fever – China
:: 22 April 2016 Zika virus infection – Papua New Guinea
:: 22 April 2016 Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia
:: 21 April 2016 Elizabethkingia – United States of America
:: 21 April 2016 Zika virus infection – Peru
:: 20 April 2016 Zika virus infection – Saint Lucia

.
Highlights
Process to elect next Director-General of WHO begins
April 2016 — Member States can now nominate candidates to be the new head of WHO, the global public health body. This is the first step in a rigorous process which will culminate in a final vote at the World Health Assembly in May 2017.

Health and social effects of nonmedical cannabis use
April 2016 — Cannabis is the most commonly used psychoactive drug across the globe. A new WHO report examines nonmedical cannabis use, with a focus on the impact of cannabis on young people and the effects of long-term frequent use.

Global Leprosy Strategy 2016-2020
April 2016 — WHO’s new global leprosy strategy, “Accelerating towards a leprosy-free world”, focuses on strengthening government ownership and partnerships, stopping leprosy and its complication, and ending discrimination while promoting inclusion.

Yellow fever vaccination campaign extended in Angola
April 2016 — With 250 deaths and 1908 suspected cases of yellow fever reported since December 2015, Angola’s Ministry of Health, WHO, and partners have extended the vaccination campaign to 2 of the 5 provinces reporting local transmission in Angola.

.

:: WHO Regional Offices
WHO African Region AFRO
:: African countries withdraw type 2 component of polio vaccine
Brazzaville, 22 April 2016 – As the world gets closer to global polio eradication, all 47 countries in the African Region are joining the rest of the world to switch from trivalent Oral Polio Vaccine (tOPV) to bivalent Oral Polio Vaccine (bOPV) in routine immunization schedules.
:: Angola extends yellow fever vaccination campaign to Huambo and Benguela provinces
19 April 2016 – As Angola grapples with its worst yellow fever outbreak in decades, the Ministry of Health, with the support of the World Health Organization (WHO) and partners have extended the vaccination campaign beyond the capital Luanda into Huambo and Benguela – 2 of the other 5 provinces reporting local transmission.

WHO Region of the Americas PAHO
:: Some 60 million people set to benefit from vaccines during Vaccination Week in the Americas (04/22/2016)

WHO South-East Asia Region SEARO
:: One year on, health partners review Nepal quake response, call for scaling up emergency preparedness 21 April 2016
:: WHO launches new global strategy seeking accelerated efforts to end leprosy 20 April 2016

WHO European Region EURO
:: From over 90 000 cases to zero in two decades: the European Region is malaria free 20-04-2016

WHO Eastern Mediterranean Region EMRO
:: National polio immunization campaign concludes in Yemen
Sana’a, 21 April 2016 – This week, a national house-to-house polio immunization campaign, organized by the Ministry of Public Health and Population and supported by WHO and UNICEF, concluded in Yemen. More than 4.5 million children under the age of 5 were successfully vaccinated by more than 40 000 health workers. Yemen has been polio free since 2006.
:: Libya completes first polio campaign since 2014 21 April 2016
:: Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks 21 April 2016
:: Keeping up the fight against polio: maintaining population immunity in Jordan
19 April 2016

WHO Western Pacific Region
:: Ending malaria: A priority in the Western Pacific Region
MANILA, 22 April 2016 – On World Malaria Day (25 April), the World Health Organization (WHO) in the Western Pacific Region calls on governments and partners to accelerate malaria control and elimination efforts in the Region and beyond by 2030.

CDC/ACIP [to 23 April 2016]

CDC/ACIP [to 23 April 2016]
http://www.cdc.gov/media/index.html
[see Zika coverage above which includes CDC briefing content]

.
MMWR April 22, 2016 / Vol. 65 / No. 15
:: Patterns in Zika Virus Testing and Infection, by Report of Symptoms and Pregnancy Status — United States, January 3–March 5, 2016
:: Notes from the Field: Development of a Contact Tracing System for Ebola Virus Disease — Kambia District, Sierra Leone, January–February 2015
:: Announcement: World Malaria Day — April 25, 2016